Abstract
Intermittent claudication is one of the most important characteristics of Lumber Canal Stenosis (LCS). We analyzed 54 partients who suffered from intermittent claudication and divided these patients into 2 groups. The patients who became non-ambulatory mainly because of severe pain will be referred to as the Pain Grop. The patients who became non-ambulatory mainly because of numbness will be referred to as the Numbness Group.
The population of the pain group was 23 or 43% of the cases, the population of the numbness group was 31 or 57% of the cases. We discoverd some characteristic differences between the 2 groups. 87% of the patients who were over 70 years old belonged to the numbness group. Acording to the internatinal classification of LCS, the ratio of the combined type is high in the pain group. The period from the onset to surgery for the pain group was a short one (on average 2 yrs. 9 mos.), while the period for the numbness group was a long one (avg. 4 yrs.). The period from onset to intermittent claudication for the pain proup was a short one (avg. 1 yr. 3 mos.). 65% of the pain group experienced weakness of muscle strength compared to 78% of the numbness group. With regards to sensory disturbance and weakness of muscle strength, the pain group tended to be unilateral while the numbness group tended to be bilateral.
As for the improvment of intermittent claudication after surgery, using the JOA score, the pain group had a better score than the numbness group.
We believe that symptoms for members of the pain group tended to appear in the early stage of LCS while the symptoms for the numbness group tended to appear in the later stage. The reason for this is that stimulation and inflamation of nerve cause pain in the early stage while nerve degeneration progressed and caused numbness in the later stage.
In conclusion we have to consider the situation of the cauda equina and the lumbar nerve root in order to treat claudication.
